Health Benefits Administration
Streamline your health benefits administration services with an integrated, quality-assured solution backed by a robust team of experts.
Looking for a reliable, quality source to manage all of the administrative services encompassing your self-insured health benefits? Populytics is built upon a rich foundation of health benefits administration experience, a superior technology infrastructure, and an integrated network of process-oriented applications. Populytics’ strength is its ability to balance the discipline and structure required to adjudicate a benefit plan with the agility needed to serve the unique needs of each self-funded health plan. Our secure, online self-service web portal provides the tools and resources needed at your fingertips—view and download claims data, see Explanation of Benefits (EOBs), review eligibility, order ID cards, find a doctor, send and receive secure communications, and much more!
Our Team Comprises:
- Skilled claims analysts and technicians
- Experienced quality and compliance assurance specialists
- Dedicated call center representatives
Services Include:
- Plan design consultation
- Claims processing—all health plan-related lines
- Eligibility intake, maintenance and coordination of benefits
- Pharmacy Benefit Manager (PBM), network integration and claims repricing
- Identification card issuance
- Disbursements, member and provider benefit reporting
- Protection of subrogation rights, third party recovery management
- Management of banking and funds transfer
- Stop loss filings and related services
- Monthly, quarterly and annual utilization, enrollment and financial reporting
- COBRA and HIPAA administration
Populytics has expertise in managing other self-funded ancillary plans including vision plans, dental plans and wellness programs. Further, Populytics can manage flexible spending, health savings and other consumer-directed health plans.
Unifying & Retaining Employees
